DR. MARK D JACKSON (NPI# 1023015005) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023015005 |
| Entity Type | Individual |
| Full Name | DR. MARK D JACKSON |
| Credential | OD |
| Practice Address |
1250 E Magnolia St Fort Collins CO 80524-2702 |
| Practice Telephone | 9702240606 |
| Practice Fax Number | 9704939309 |
| Mailing Telephone | 9702240606 |
| Mailing Fax Number | 9704939309 |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2011-10-19 |
| NPI Deactivation Date | 03/20/2006 |
| NPI Reactivation Date | 2006-03-31 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 2187 | CO | Eye and Vision Services Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134755721 | Mark Wayne Jackson | Occupational Therapist | 8608 Marys Creek Dr, Benbrook, TX 76116-7624 | 2020-03-16 |
| 1811409535 | Mark Jackson | Driver | 26048 Pine Tree Rd, Rhoadesville, VA 22542-8549 | 2017-11-03 |
| 1932488194 | Mark Monroe Jackson | Social Worker | 119 Kona Dr, Galveston, TX 77554-8623 | 2011-08-05 |
| 1477860757 | Mark Allan Jackson | Technician, Other | 322 S Jefferson St, Louisa, KY 41230-1316 | 2010-09-08 |
| 1063620516 | Mark Kent Jackson | Pharmacist | 605 Hwy 31 South, Suite D, Athens, AL 35611 | 2007-05-18 |
| 1528289881 | Mark Jackson | Preventive Medicine | 10 Standing Rock Agency Avenue, Fort Yates, ND 58538 | 2007-05-02 |
| 1255470209 | Mark F Jackson | Anesthesiology | 3930 Us 1 S, Saint Augustine, FL 32086-7089 | 2007-02-06 |
| 1598788796 | Mark K Jackson | Dentist | 7007 Old Sauk Road, Madison, WI 53717 | 2006-07-26 |
| 1003877077 | Mark R. Jackson | Emergency Medicine | 1474 E Erda Way, Tooele, UT 84074-9737 | 2006-03-30 |
| 1073585238 | Mark A Jackson | Family Medicine | 1000 Pavilions Circle, Mark A Jackson Md Plc, Traverse City, MI 49684 | 2006-02-02 |
| Street Address |
1250 E MAGNOLIA ST |
| City | FORT COLLINS |
| State | CO |
| Zip Code | 80524-2702 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629631304 | Jared Overman | Pharmacist | 1250 E Magnolia St, Fort Collins, CO 80524-2702 | 2019-04-17 |
| 1568925790 | Tina Evans | Pharmacist | 1250 E Magnolia St, Fort Collins, CO 80524-2702 | 2019-04-14 |
| 1164985354 | Meera Martin | Pharmacist | 1250 E Magnolia St, Fort Collins, CO 80524-2702 | 2019-04-13 |
| 1972066140 | Brett Vanvuren | Pharmacist | 1250 E Magnolia St, Fort Collins, CO 80524-2702 | 2019-04-12 |
| 1376020511 | Ngoc H Phan | Optometrist | 1250 E Magnolia St, Fort Collins, CO 80524-2702 | 2018-07-20 |
| 1396878328 | Jackson Eyecare, PC | Optometrist | 1250 E Magnolia St, Fort Collins, CO 80524-2702 | 2007-03-13 |
| 1376628941 | Wal-mart Stores, Inc. | Technician/Technologist | 1250 E Magnolia St, Fort Collins, CO 80524-2754 | 2006-10-25 |
| 1700803087 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 1250 E Magnolia St, Fort Collins, CO 80524-2702 | 2006-07-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669084612 | Summitstone Health Partners | Clinic/Center | 1008 Patton St., Fort Collins, CO 80524 | 2020-08-20 |
| 1396355244 | Kidstuff Child and Family Counseling, P.C. | Psychologist | 1006 Robertson St., Ste. 120, Fort Collins, CO 80524 | 2020-08-05 |
| 1215561857 | Transform The Nest LLC | Social Worker | 405 A Matthews Street, Fort Collins, CO 80524 | 2020-02-22 |
| 1326671413 | Laura Ann Doyle | Registered Nurse | 8775 County Road 80.5 # 5, Fort Collins, CO 80524 | 2020-02-17 |
| 1013496835 | Stepheny Nicol Chapple | Psychologist | 701 S College Drive, 201, Fort Collins, CO 80524 | 2018-08-13 |
| 1609372432 | Tracy Jo Close | Counselor | 1031 Robinson Street, Fort Collins, CO 80524 | 2018-04-02 |
| 1831617828 | Rachel Elizabeth Brenner | Counselor | 151 W Lake Rd, Csu Health Network Counseling Services, Fort Collins, CO 80524 | 2017-08-30 |
| 1205366820 | Victoria Marie Sechser | Specialist/Technologist | 1102 Peterson St, Fort Collins, MN 80524 | 2017-06-15 |
| 1013367705 | Smith Street LLC | Day Training, Developmentally Disabled Services | 308 Smith St., Fort Collins, CO 80524 | 2016-06-14 |
| 1811344989 | Ignite Speech-language Services | Clinic/Center | 3921 Celtic Lane, Fort Collins, CO 80524 | 2016-05-18 |
| Find all providers in zip 80524 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154928331 | Madison Street Provider Network Inc | Optometrist | 4103 Boardwalk Dr Unit 100, Fort Collins, CO 80525-5933 | 2020-10-01 |
| 1467079137 | Rebecca Weinberger | Optometrist | 3501 S Shields St, Fort Collins, CO 80526-2583 | 2020-06-29 |
| 1699259143 | Poudre Valley Eyecare LLC | Optometrist | 1820 S College Ave Ste B, Fort Collins, CO 80525-1423 | 2018-09-20 |
| 1306332101 | Joshua Evans Brooks | Optometrist | 375 E Horsetooth Rd Bldg 5 Ste 201, Fort Collins, CO 80525 | 2018-07-03 |
| 1255719043 | Visionzone LLC | Optometrist | 383 W Drake Rd Ste 103, Fort Collins, CO 80526-2884 | 2015-05-12 |
| 1033454806 | Edge Optics LLC | Optometrist | 706 S College Ave, Suite 101, Fort Collins, CO 80524-9817 | 2012-12-06 |
| 1134480973 | Jennifer Havrilla | Optometrist | 425 Crows Nest Ct, Fort Collins, CO 80525-3118 | 2012-06-07 |
| 1043523129 | Lorena Delagarza | Optometrist | 3100 S College Ave, Suite 120, Fort Collins, CO 80525-2643 | 2010-07-19 |
| 1508198433 | Eyecare for You LLC | Optometrist | 4050 S Timberline Rd, Suite 120, Fort Collins, CO 80525-6032 | 2010-02-03 |
| 1275770117 | Front Range Vision Care, Pllc | Optometrist | 204 Maple Street, Suite 103, Fort Collins, CO 80524 | 2009-01-14 |
| Find all providers in FORT COLLINS | ||||
| City | FORT COLLINS |
| Zip Code | 80524 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.